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Right arrow Esophagus - cancer

Eur J Cardiothorac Surg 2007;32:445-448. doi:10.1016/j.ejcts.2007.06.014
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Management of esophageal cancer in patients aged over 80 years

Alberto Ruola, Giuseppe Portaleb, Carlo Castorob,*, Stefano Meriglianoa, Francesco Cavallina, Giorgio Battagliab, Silvia Michielettoa, Ermanno Anconab

a Department of Surgery and Organ Transplant, Clinica Chirurgica III, University of Padova School of Medicine, Padova, Italy
b Istituto Oncologico Veneto (IOV-IRCCS), Padova, Italy

Received 28 March 2007; received in revised form 9 June 2007; accepted 11 June 2007.

* Corresponding author. Address: Istituto Oncologico Veneto (IOV-IRCCS), University of Padova School of Medicine, Via Giustiniani 2, 35128 Padova, Italy. Tel.: +39 049 821 8842; fax: +39 049 821 3151. (Email: carlo.castoro{at}unipd.it).

Background: Important advances in the management of cancer of the esophagus and esophagogastric junction have occurred in the last decades, making treatment possible even in elderly patients. Unfortunately there is little information on management of esophageal cancer in octogenarian patients. The aim of this study was to evaluate the treatment results of esophageal and esophagogastric junction cancer in a single institution over a 14-year period in patients ≥80 years of age. Methods: Clinicopathological characteristics and management strategies were studied in patients ≥80 years old with cancer of the esophagus or esophagogastric junction, referred to our department and treated between 1992 and 2005. Results: There were 62 patients ≥80 years: 12 underwent surgical resection and 50 were not resected. There were no perioperative deaths. The morbidity rate was 33%. Most non-resected patients had an endoscopic prosthesis. The median survival for the overall group was 5.4 months: 14.6 and 5.1 in resected and non-resected patients, respectively. Conclusions: Even in octogenarian patients – with limited comorbidities and fit for surgery – esophagectomy may be regarded as a valid treatment option. Unfortunately this remains possible only in a small minority of 80–90-year old patients. In the remainder, endoscopic treatments – namely prosthesis placements, with chemoradiotherapy when possible – are the alternatives.

Key Words: Esophageal and esophagogastric junction cancer • Elderly • Octogenarians • Esophagectomy • Palliation






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.